What You Should Know About Common Dementia Medications

Written by Wendy Leonard, MPH
| Published on October 6, 2014Medically Reviewed by Kenneth R. Hirsch, MD
on October 6, 2014

Dementia
is a general term for the loss of memory caused by physical changes in the
brain. Alzheimer’s is the most common type of dementia. Unfortunately, there
are currently no medications that can reverse or halt disease progression for
most of the dementias. There are five Alzheimer’s disease (AD) medications approved
by the FDA that have been shown to provide some symptom relief. However, they
can’t improve the underlying brain damage or even always clearly decrease the
speed of cognitive decline.

The
FDA has approved a group of medications for mild to moderate AD known
collectively as cholinesterase inhibitors. These may delay or prevent Alzheimer’s
symptoms from worsening, and they may help manage some of the behavioral
symptoms that accompany a diagnosis of AD. These medications include donepezil
(Aricept), galantamine (Razadyne), and rivastigmine (Exelon). The first
cholinesterase inhibitor FDA approved for AD was known as tacrine (Cognex).
It’s been removed from the market due to safety concerns.

For
moderate to severe AD, the FDA has approved and additional medication that is
not a cholinesterase inhibitor. This
medication is known as memantine (Namenda). Its primary use is to potential
delay the decline in cognitive and behavioral symptoms in people with moderate
to severe AD. This permits certain patients to retain some routine
functionality longer than they would have without the medication. Donepezil has
also been approved for use in more advanced AD.

The effectiveness of
these medications is highly variable. Whatever effectiveness they do have tends
to diminish over time. According to the Alzheimer’s
Association
there is also research suggesting that some of the AD medications may provide
some benefit for vascular dementias and Parkinson's dementia. While these
medications are intended to stop the progression of Alzheimer’s disease, additional
medications may be required to alleviate the many challenging symptoms. These
include:

antidepressants

anti-anxiety
medication

sleep
aids

antipsychotics

Here are some of the commonly
prescribed medications and their uses.

Generic Name

(Brand Name Example)

Medication Use

Donepezil (Aricept)

Used to delay or slow the
symptoms of AD.
• loses its effect over time
• used for mild, moderate, and severe AD
• does not prevent or cure AD

* may help reduce behavioral
symptoms in some people with Parkinson's dementia

Galantamine (Razadyne)

Used to prevent or slow the
symptoms of AD.
• loses its effect over time
• used for mild to moderate AD
• comes in pill form or as a skin patch
• does not prevent or cure AD

* may provide some benefit for
vascular dementias

Memantine (Namenda)

Used to delay or slow the
symptoms of AD.
• loses its effect over time
• used for moderate to severe AD
• sometimes given with donepezil (Aricept), rivastigmine (Exelon), or galantamine
(Razadyne)
• does not prevent or cure AD

Citalopram (Celexa)

Used to reduce depression and
anxiety.
• may take four to six weeks to work
• sometimes used to help people get to sleep

Sodium valproate (Depakote)

Used to treat severe
aggression.
• also used to treat depression and anxiety

Mirtazepine (Remeron)

Used to reduce depression and
anxiety.
• may take four to six weeks to work
• sometimes used to help people get to sleep

Carbamazepine (Tegretol)

Used to treat seizures
• also used to treat depression and anxiety

Sertraline (Zoloft)

Used to reduce depression and
anxiety.
• may take four to six weeks to work
• sometimes used to help people get to sleep

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